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Assessment of the underestimation of childhood diarrhoeal disease burden in Israel

  • T. ZIV (a1), A. D. HEYMANN (a1) (a2) (a3), J. AZURI (a2) (a3), M. LESHNO (a4) (a5) and D. COHEN (a1)...
Summary
SUMMARY

We determined the extent by which mandatory reporting on isolates of Shigella and Salmonella underestimates the burden of diarrhoeal diseases in individuals aged <17 years in Israel and examined paediatricians' knowledge, attitudes and practices related to patient visits with diarrhoeal diseases. Sources of data were a nationwide population-based telephone survey for presence of diarrhoeal diseases, Maccabi Healthcare Services databases and a mail survey among its paediatricians. Monte Carlo simulation and rate estimates for all stages, from visit to physician to reporting on a culture-confirmed case of shigellosis or salmonellosis, were used to determine the underestimation factor. Of 1492 children, 5·7% reported a diarrhoeal episode during the 2 weeks prior to interview. The rate of visiting a physician with and without fever was 86% and 16%, respectively. A stool culture was performed for around 20% of patients and the isolation rates were 7·1% for Shigella and 2·1% for Salmonella. Paediatricians (n=214) ranked very young age of patient and the complaint ‘bloody diarrhoea’ as the most important determinants. We estimated that one reported isolate of Shigella or Salmonella represented 152 diarrhoeal episodes of all aetiologies. This estimate is important for further assessments of the true burden of diarrhoeal diseases.

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Corresponding author
*Author for correspondence: D. Cohen, Ph.D., Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, P.O.B. 39040, Ramat Aviv, Tel Aviv, 69978, Israel. (Email: dancohen@post.tau.ac.il)
References
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1.Guerrant RL, et al. Practice guidelines for the management of infectious diarrhea. Clinical Infectious Diseases 2001; 32: 331350.
2.Tan LJ, et al. Diagnosis and management of foodborne illnesses – a primer for physicians and other health care professionals – introduction and clinical considerations. American Medical Association, February 2004 (http://www.ama-assn.org/ama/pub/physician-resources/medical-science/food-borne-illnesses/diagnosis-management-foodborne.shtml). Accessed 15 July 2009.
3.Benifla M, et al. Epidemiologic characteristics of pediatric emergency room referral and hospitalization for diarrhea in the Negev. Harefuah 1997; 132: 534538.
4.Kuchenmüller T, et al. Estimating the global burden of foodborne diseases – a collaborative effort. Eurosurveillance 2009; 14(18).
5.Majowicz SE, et al. The global burden of nontyphoidal Salmonella gastroenteritis. Clinical Infectious Diseases 2010; 50: 882889.
6.Israeli Ministry of Health. Annual report 2004. Department of Epidemiology, Ministry of Health, Israel.
7.WHO. Fighting disease, fostering development. World Health Report, 1996. World Health Organization.
8.Guerrant RL. Why America must care about tropical medicine: threats to global health and security from tropical infectious diseases. American Journal of Tropical Medicine and Hygiene 1998; 59: 316.
9.Gold R. Overview of the worldwide problem of diarrhea. Drugs 1998; 36 (Suppl. 4): 15.
10.Guerrant RL, et al. Diarrhea in developed and developing countries: magnitude, special settings and etiologies. Reviews of Infectious Diseases 1990; 12 (Suppl.): S41–50.
11.Hird S, et al. Meeting report: second annual meeting of the World Health Organization initiative to estimate the global burden of foodborne diseases. International Journal of Food Microbiology 2009; 133: 210212.
12.Thomas MK, et al. Estimated numbers of community cases of illness due to Salmonella, Campylobacter and Verotoxigenic Escherichia coli: pathogen-specific community rates. Canadian Journal of Infectious Diseases and Medical Microbiology 2006; 17: 229234.
13.MacDougall L, et al. Under-reporting of infectious gastrointestinal illness in British Columbia, Canada: who is counted in provincial communicable disease statistics? Epidemiology and Infection 2008; 136: 248256.
14.Hall G, et al. Estimating community incidence of Salmonella, Campylobacter, and Shiga toxin-producing Escherichia coli infections, Australia. Emerging Infectious Diseases 2008; 14: 16011609.
15.Kubota K, et al. The human health burden of foodborne infections caused by Campylobacter, Salmonella, and Vibrio parahaemolyticus in Miyagi Prefecture, Japan. Foodborne Pathogens and Disease 2008; 5: 641648.
16.CDC. Foodnet surveillance – burden of illness pyramid (www.cdc.gov/foodnet/surveillance_pages/burden_pyramid.htm). Accessed 15 July 2009.
17.Scallan E, et al. Factors associated with seeking medical care and submitting a stool sample in estimating the burden of foodborne illness. Foodborne Pathogens and Disease 2006; 3: 432438.
18.Hennessy TW, et al. A national outbreak of Salmonella enteritidis infections from ice cream. New England Journal of Medicine 1996; 334: 12811286.
19.Hedberg CW, Hirschhorn N. Annotation: why foodborne disease surveillance is critical to the safety of out food supply. American Journal of Public Health 1996; 86: 10751076.
20.Tilden J, et al. A new route of transmission for Escherichia coli: infection from dry fermented salami. American Journal of Public Health 1996; 86: 11421145.
21.Blaster MJ. How safe is our food? – lessons from an outbreak of salmonellosis. New England Journal of Medicine 1996; 334: 13241325.
22.Hilborn ED, et al. A multistate outbreak of Escherichia coli O157:H7 infections associated with consumption of mesclun lettuce. Archives of Internal Medicine 1999; 159: 17581764.
23.Herwaldt BL, Beach MJ. The return of Cyclospora in 1997: another outbreak of cyclosporiasis in North America associated with imported raspberries. Annals of Internal Medicine 1999; 130: 210220.
24.Hennessy TW, et al. Survey of physician diagnostic practices for patients with acute diarrhea: clinical and public health implications. Clinical Infectious Diseases 2004; 38 (Suppl. 3): S203–211.
25.Jones TF, et al. A population based estimate of the substantial burden of diarrhoeal disease in the United States; FoodNet, 1996–2003. Epidemiology and Infection 2007; 135: 293301.
26.Majowicz SE, et al. A common, symptom-based case definition for gastroenteritis. Epidemiology and Infection 2008; 136: 886894.
27.White AA.Response rate calculation in RDD telephone health surveys: current practices. Reprinted by the National Center for Health Statistics from the Proceedings of the American Statistical Association, 1983.
28.Israel Center for Disease Control. A survey for estimating the array of enteric morbidity in Israel [in Hebrew]. Israel Center for Disease Control, 1996, Number 103.
29.Scallan E, et al. Prevalence of diarrhoea in the community in Australia, Canada, Ireland, and the United States. International Journal of Epidemiology 2005; 34: 454460.
30.Vally H, et al. Higher rate of culture-confirmed Campylobacter infections in Australia than in the USA: is this due to differences in healthcare-seeking behaviour or stool culture frequency? Epidemiology and Infection 2009; 137: 17511758.
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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
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